Treatment of Pectoralis Trigger Points in Patients With Pseudo Angina (GT-LIC)

July 22, 2026 updated by: Muhammad Muneeb Jafar, University of Faisalabad

Comparative Effects of Graston Technique Versus Local Ischemic Compression on Trigger Points of Pectoralis Major and Minor Among Pseudo-angina Patients

Pseudo-angina is a musculoskeletal condition characterized by chest pain that resembles angina but occurs due to non-cardiac causes, particularly myofascial trigger points in the chest wall muscles. Trigger points in the pectoralis major and minor muscles may contribute to pain, discomfort, and functional limitations by affecting muscle activity and movement. Manual therapy techniques such as the Graston Technique and Local Ischemic Compression (LIC) are commonly used to manage soft tissue dysfunction and myofascial trigger points. This study aims to compare the effects of the Graston Technique and Local Ischemic Compression on pain reduction and functional improvement in patients with pseudo-angina.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

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Detailed Description

This is Multiple-center, randomized controlled trail. Participants age 25-50 years with diagnosed pseudo angina will be referred from cardiology department of Aziz Fatima and Faisal hospital to Madina Teaching hospital (MTH) Physiotherapy ward and Jafar Physiotherapy Clinic. After informed consent Participants will be randomly assign to one of two parallel groups using a random number generator. Group A (Experimental): Receive Graston technique 3 sessions per week for total duration 4 weeks. Group B (Active Comparator) receive the LIC 3 sessions per week for total duration 4 weeks. Outcome measures (pain via NPRS, Shoulder Pain and Disability Index (SPADI)) are taken at baseline and end of treatment. Data will be analyzed using Spss version 20.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
36

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

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Study Contact Backup

Study Locations

  • Pakistan
    • Punjab Province
      • Faisalābad, Punjab Province, Pakistan, 38000
        • The University of Faisalabad

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Participants which fulfill the Simon's Trigger Point Diagnostic Criteria
  • Referred by Cardiologist • Patients with Trigger Points in chest Muscles and left Pectoralis Major and Minor muscles.

Exclusion Criteria:

  • Spinal Deformity • Gastric Problems • Any cardiac disease • Heart Burns • Panic Attacks • Pleurisy • Pulmonary Embolism • Pericarditis.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Graston Technique
articipants assigned to this arm received the Graston Technique, an instrument-assisted soft tissue mobilization intervention, applied to the identified myofascial trigger points of the pectoralis major and pectoralis minor muscles. The intervention was performed after a gentle Z-stretch of the targeted muscles as baseline treatment. A stainless-steel Graston instrument was applied using controlled strokes at approximately a 45° angle to the skin surface, following the direction of the muscle fibers and across the fibers to mobilize soft tissue restrictions. The treatment was applied for approximately 40-120 seconds over each targeted area.
Other: Graston Technique
A stainless-steel Graston instrument was applied using controlled strokes at approximately a 45° angle to the skin surface, following the direction of the muscle fibers and across the fibers to mobilize soft tissue restrictions. The treatment was applied for approximately 40-120 seconds over each targeted area.
Experimental: Local Ischemic Compression
Participants assigned to this arm received LIC applied to the identified myofascial trigger points of the pectoralis major and pectoralis minor muscles. Following a gentle Z-stretch of the targeted muscles as baseline treatment, sustained manual pressure was applied gradually over each trigger point until a tolerable level of discomfort was achieved. The compression was maintained for approximately 90 seconds per trigger point and repeated 1-3 times during each treatment session according to patient tolerance and clinical response. The technique was performed using the therapist's thumb, finger, or knuckle depending on the location and depth of the trigger point. Participants received four physiotherapy sessions over a two-week period, with sessions conducted on alternate days.
Other: Local Ischemic Compression
Sustained manual pressure was applied gradually over each trigger point until a tolerable level of discomfort was achieved. The compression was maintained for approximately 90 seconds per trigger point and repeated 1-3 times during each treatment session according to patient tolerance and clinical response. The technique was performed using the therapist's thumb, finger, or knuckle depending on the location and depth of the trigger point

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Shoulder Pain Disability Index
Time Frame: Baseline and 4 week post intervention
The Shoulder Pain and Disability Index is a well-known neutral measure for assessing the level of pain and functional impairment experienced by people with shoulder issues. It is frequently used in clinical and research settings to assess the severity of shoulder problems and track therapy efficacy. It consists of 13 elements organized into two subscales. The Pain Subscale consists of five items that determine how intense pain is in various circumstances, such as at rest or during activities. The disability subscale consists of eight items: it assesses the level of difficulty with specific everyday shoulder-related tasks, such as lifting weights or putting on a shir
Baseline and 4 week post intervention
Numeric Pain Rating Scale
Time Frame: Baseline and 4 week post intervention
NPRS was used as a primary outcome measure to evaluate pain intensity in patients with pseudo-angina. On the scale, 0 represents no discomfort and 10 represents severe pain. At rest and while engaging in activities, participants were asked to rate their level of pain.
Baseline and 4 week post intervention

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
University of Faisalabad

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

  • This citation will not be hyperlinked on ClinicalTrials.gov. The effectiveness of instrument- assisted soft tissue mobilization technique (ergonš technique), cupping and ischaemic pressure techniques in the treatment of amateur athletes΄ myofascial trigger points. Journal of Novel Physiotherapy S (3): 1-7.
  • This citation wilnot be hyperlinked on ClinicalTrails.gov. Fousekis K, Kounavi E and Doriadis S (2016) The Effectiveness of instrument- assisted soft tissue mobilization technique, cupping and ischemic pressure techniques in the treatment of amateur athlete's myofascial trigger points. Journal of Novel Physiotherapies 3(2): 1-7.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
July 25, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
October 1, 2026

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
November 1, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
July 22, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
July 22, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
July 27, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
July 27, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
July 22, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
July 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • TUF/EIRB/136/2025

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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